Surgical Treatment for Unstable Pelvic Ring Injuries



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Abstract

Treatment results for 67 patients (43 men, 24 women), aged 15–70 years, with unstable pelvic ring injuries are presented. In 15 cases conservative treatment (control group) and in 52 cases various surgical interventions (main group) were performed. In the main group of patients a strategy of two5step surgical treatment of the victims with multiple and concomitant injuries Damage control concept was applied. It included urgent stabilization of pelvic ring with external fixation devices and C-frame, bleeding arrest, final fixation within first 5–7 days after stabilization of patient’s condition. Restoration of the anterior semi5ring was performed using either external fixation device or a reconstructive plate. Stabilization of sacroiliac junction was per5 formed with cannulated screws. All patients were allowed to walk on crutches within 1–5 days after operation. In control and main groups the duration of hospitalization made up 43.7±2.5 and 25.7±3.1 days (p<0.05), respectively. Long term (1 year) treatment results were assessed by Majeed scale and SF-36 questionnaire were used. By Majeed scale excellent results in main group were achieved in 35 (67.3%), good – 11 (21%) and satisfactory – in 6 (11.5%) patients. In control group no excellent results were obtained, good results were obtained in 6 (40%) and satisfactory in 9 (60%) patients. By SF-36 questionnaire treatment results in main group statistically significant (p<0.001) surpassed the results achieved in control group. Thus, stable fixation of both anterior and posterior semirings enables to initiate early mobilization without risk of reposition loss that is very important for the patients with multiple and concomitant injuries.

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Алгоритм хирургического лечения нестабильных повреждений тазового кольца
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References

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